1/99. Massive left atrial thrombus: a case report.This case report describes a patient with aortic and mitral valvular disease who had a massive left atrial thrombus. The left atrial thrombus produced a disappearance of signs of mitral stenosis and a reversed pan diastolic mitral valve gradient. This gradient occurred in the absence of any diastolic mitral insufficiency and may have been due to artifactual lowering of the left atrial pressure by an organized left atrial clot.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/99. radiography of hydrocephalus after total parenteral nutrition.An infant with chronic diarrhea developed hydrocephalus following treatment with total parenteral nutrition (TPN) via jugular vein catheterization. Total parenteral nutrition is used when nutritional needs cannot be met adequately by oral alimentation. Serial computerized tomograms showed progression of communicating hydrocephalus. Superior sagittal sinograms demonstrated bilateral internal jugular vein occlusion with extensive venous collateralization. Lumboperitoneal shunt effectively decreased raised CSF pressure. A judicious approach to alternative venous routes for hyperalimentation is suggested. Radiographic delineation of communicating hydrocephalus by computerized tomography and superior sagittal sinography is presented.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/99. Thrombosis involving the major veins with heterozygote factor v Leiden mutation as the only risk factor.A 27-year-old man was admitted to our hospital with the complaints of swelling of his face and lower limbs. echocardiography showed minimal pericardial effusion accompanied by disordered diastolic function. cardiac catheterization was performed to rule out constrictive pericarditis. Normal pressure tracings of the right heart rule out constrictive pericarditis, however, a narrowing of the inferior vena cava was observed. Venographies of the inferior and superior vena cavae showed extensive thrombotic involvement of these great veins. Protein C, protein s, anticardiolipin antibodies, fibrinogen, antithrombin-III, activated protein c resistance, and factor v levels were in normal limits. Heterozygosity for factor v Leiden mutation was detected. We conclude that factor v Leiden mutation can cause extensive thrombotic involvement of major veins and should be considered in idiopathic thrombosis of them.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/99. Disappearance of "pseudocholangiocarcinoma sign" in a patient with portal hypertension due to complete thrombosis of left portal vein and main portal vein web after web dilatation and transjugular intrahepatic portosystemic shunt.The main portal vein web is probably a consequence of portal vein thrombosis, which is a very rare cause of portal hypertension. Principal manifestations are related to the degree of portal hypertension. In the literature, no data has been found for the treatment modality of portal vein web. We report, herein, the clinical and laboratory findings of a 38-year-old woman with angiographically proven incomplete main portal vein web and complete thrombotic occlusion of the left portal vein causing pseudocholangiocarcinoma sign (PCCS) on the common bile duct. She was treated by transjugular intrahepatic portosystemic shunt (TIPS) and membrane dilatation, which resulted in complete disappearance of collaterals and PCCS. It appears that TIPS and balloon dilatation of the portal vein web via transjugular approach was effective in decreasing portal pressure and its consequences.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/99. Hypertension due to renal artery occlusion in a patient with antiphospholipid syndrome.We report an unusual case of renovascular hypertension in a 16-year-old boy with primary antiphospholipid syndrome (PAPS), admitted to our clinic for severe drug-resistant hypertension and hypokalemia. Hormonal investigation revealed secondary aldosteronism and positive captopril test for renovascular disease. aortography confirmed the occlusion of the left renal artery. After nephrectomy, normalization of blood pressure and secondary aldosteronism occurred. Presently the patient remains in good health, receiving warfarin anticoagulant therapy. PAPS is defined by the presence of antiphospholipid antibodies and recurrent thrombosis. Arterial thrombosis (29%) appears to be less prevalent than venous thrombosis. Thrombotic microangiopathy of the kidney is frequently observed but renal artery occlusion, as seen in our patient, is unusual.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/99. hypertension, renal vein thrombosis and renal failure (occurring in a patient on an oral contraceptive agent).A case of accelerated hypertension leading to renal failure in a young woman taking an oral contraceptive agent is described. During the course of her disease the left kidney was documented to decrease in size. Renal vein plasma renin activity was found to be elevated on the left in the absence of renal artery stenosis. Left nephrectomy, prompted by continuing poor blood pressure control, resulted in amelioration of the hypertension. Left renal vein thrombosis was found at surgery. It is suggested that renal vein thrombosis was a contributing factor to this patient's accelerated hypertension and may represent an unusual thrombotic complication of oral contraceptives.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/99. Extensive pulmonary arterial thrombi in situ in association with atrial septal defect.A 48-year-old woman with cyanosis was referred for investigation of atrial septal defect (ASD). blood gas analysis on admission revealed moderate hypoxemia, and a pressure study during right heart catheterization revealed pulmonary hypertension (PH). Spiral computed tomography (CT) scan disclosed extensive thrombi in dilated large symmetrical pulmonary arteries with clear lung fields, and large strand-like thrombi on the inner surface of the pulmonary arterial wall along the vascular curvature were visualized by virtual CT angioscopic imaging. The thrombi were eventually considered to be not thromboemboli but thrombi in situ, because no segmental or larger defects were detected in the lung perfusion scan, although it showed cardiovascular imprints and an inhomogeneously decreased perfusion pattern. Pulmonary thrombi in situ are an uncommon manifestation in patients with ASD, and have not been described from the evidence of both CT and lung perfusion scans. The findings indicate that pulmonary thrombi in situ are not associated with occlusion of the large pulmonary arteries and the resultant development of PH. The patient was conservatively treated with medication, and the pulmonary thrombi did not show significant change with anticoagulant therapy. She died suddenly at the age of 51 years.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/99. orbital cellulitis and cavernous sinus thrombosis after cataract extraction and lens implantation.orbital cellulitis as a complication of ophthalmic surgery is uncommon. We treated a patient who had orbital cellulitis and cavernous sinus thrombosis three weeks after uncomplicated cataract extraction and lens implantation. Sinus x-rays showed sphenoid sinus opacification. Computed tomographic scan confirmed the sphenoid sinus disease, and no abscess was found. The patient recovered completely after treatment with intravenous antibiotics. Most orbital cellulitis is secondary to sinus disease. The trauma of surgery and the retrobulbar block must be considered possible causative factors in this patient, but sinus disease is still the most likely cause. Intraocular inflammation did not increase during the illness although the intraocular pressure rose from 14 to 23mmHg.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/99. Overestimation of severity of mitral stenosis during cardiac catheterization due to a large left atrial thrombus.We report a case of mitral stenosis with a large left atrial thrombus which was obstructing pulmonary venous inflow where the conventional use of the pulmonary capillary wedge pressure as an approximation of the left atrial pressure during diagnostic cardiac catheterisation led to the over-estimation of the severity of mitral stenosis.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
10/99. Successful treatment of chronic thromboembolic pulmonary hypertension with inhaled nitric oxide after right ventricular thrombectomy.We report a case of a 42-year-old male with chronic thromboembolic pulmonary hypertension. His preoperative examination revealed severe hypoxemia (PaO2 48 mmHg, PaCO2 34 mmHg in room air), a mass in the right ventricle and severe pulmonary hypertension (pulmonary arterial pressure 70/33 mmHg). We successfully performed right ventricular thrombectomy to prevent further embolization from the right ventricular thrombus. Using inhaled low dose nitric oxide (NO) during perioperative period, weaning from cardiopulmonary bypass and ventilator were easily done. In this case, inhaled NO was successfully administered for the perioperative management of chronic pulmonary hypertension.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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